title: Chest radiography after endotracheal tube placement: is it necessary or not?
abstract: OBJECTIVE
  The aim of this study was to evaluate the necessity of chest x-ray (CXR) in detecting the endotracheal tube (ETT) misplacement after the intubation.
  
  
  METHODS
  In this cross-sectional study, we took a CXR after confirming the ETT placement by physical examination. The distance between the tip of the ETT and carina was then evaluated and graded as satisfactory if it was more than 2 cm.
  
  
  RESULTS
  During the study period, 381 patients were intubated in the emergency department (ED). According to the CXR findings, the distance between the ETT and carina was more than 2 cm in 336 patients (88.2%), whereas it was less than 2 cm in 45 patients (11.8%). Fourteen ETTs (3.6%) were judged to be too low with 6 (1.5%) of these being right bronchus intubations. One patient had a CXR confirming left bronchial intubation.
  
  
  CONCLUSIONS
  Although ED intubations have high success rate, the complications of inappropriate intubations are highly remarkable that postintubation CXR remains a necessary step to minimize the misplacement of the tube.
authors.affiliation: Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran. hoseinnejad@TUMS.ac.ir
authors.forename: Hooman
authors.initials: H
authors.lastname: Hossein-Nejad
authors.forename: Pooya
authors.initials: P
authors.lastname: Payandemehr
authors.forename: Seyed Ali
authors.initials: SA
authors.lastname: Bashiri
authors.forename: Hamid Hossein-Nejad
authors.initials: HH
authors.lastname: Nedai
mesh_terms: D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic / Q000379:methods